Individual
NICOLE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
409 E OAKLAND AVE UNIT B, OAKLAND, FL 34787-3070
(407) 654-5455
Mailing address
4615 EXPLORER DR APT 207, WEST MELBOURNE, FL 32904-9191
(607) 267-2706
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT 15543
FL
Other
Enumeration date
04/29/2014
Last updated
04/29/2014
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